Fat-out fiction

Imagine you’re a smoker with trouble quitting. Then somebody authoritatively assures you that centuries of observation and thousands of published studies on tobacco’s harm are bunk borne of hysteria. Moderate smoking is actually good for you, while chain-smoking is fine if you exercise a bit.

And if you believe that, I’ve got a bridge in Brooklyn to sell you — or a new book by Colorado law professor Paul Campos called “The Obesity Myth.”

Hippocrates himself, two millennia ago, connected being overweight with sudden death. So did insurance actuaries of the 19th century. Last year, the Journal of the American Medical Association reported that white men ages 20 to 30 with a Body Mass Index (BMI) greater than 45 lost 13 years of life compared with those with a BMI below 25. (A BMI over 25 is considered overweight.) At the same time, the Annals of Internal Medicine reported six to seven years of lost life for obese 40-year-old nonsmokers, putting them at the same risk as smokers who weren’t obese.

Mr. Campos knows he’s swimming against a tsunami of peer-reviewed medical literature and has no health background. (Full disclosure: I’m also a lawyer but became a full-time health writer 17 years ago). He counters this in several ways.

First, he claims there’s a medical establishment conspiracy so immense the Illuminati are amateurs by comparison. Then he presents “size acceptance” activists as the real experts, heavily drawing on their assertions. Finally, he selects individual medical studies and tortures them until they confess to his truth, while ignoring thousands of studies even a skilled jurist can’t twist.

Mr. Campos tries desperately to convince readers thinness is the real health problem, notwithstanding reports such as the one in the Jan. 1, 1998, New England Journal of Medicine that observed 300,000 men and women over 12 yeas. “It’s the very lean weight that is associated with the best survival rate,” the lead researcher concluded.

Instead, Mr. Campos repeatedly asserts that in some studies the thinnest died first, ignoring the author’s caveats that this result disappears when those are excluded whose thinness was due to smoking or a wasting disease such as cancer.

Thus, the landmark 1995 New England Journal of Medicine study that followed more than 115,000 women for 19 years found, “Among women who had never smoked, the leanest women in the cohort [those with BMIs below 19.0] had the lowest mortality.” Deaths “were lowest among women whose weights were below the range of recommended weights in the current U.S. guidelines.”

Actually, only a small part of Mr. Campos’ book even addresses the health effects of obesity. Most of it simply assumes his conclusion, so he can pontificate on peripheral issues such as (honestly) “How weight-loss mania fueled the impeachment of Bill Clinton.”

Therefore, Mr. Campos devotes less than two pages to pooh-poohing the notion that obesity causes heart disease, relying on quotes and select studies dating back to 1950. Yet enter “obesity” and “heart disease” into the PubMed online database of science and medical journals and you’ll pull up more than 2,900 studies. Why all this research on a nonexistent phenomenon? The latest such study at this writing appears in the May 2004 American Heart Journal and comes to the standard conclusion that, “BMI appeared to have a positive, graded relation with postmyocardial infarction death.” Translation: The heavier you are, the more likely you’ll die of a heart attack.

Another PubMed search reveals many thousands of studies associating obesity with stroke, cancer, diabetes and a gargantuan list of lesser illnesses. Meanwhile, a just-released Rand Corp. study found a striking increase in disability among Americans from obesity, while a January 2004 Obesity Research study concluded, “Annual U.S. obesity-attributable medical expenditures are estimated at $75 billion.”

How strange that a harmless or even beneficial medical condition could prove so expensive. As to Mr. Campos’ advocacy of what’s called “fat-but-fit,” yes fat exercisers will be fitter than fat nonexercisers. But fat is a tremendous impediment to exercise. Studies also repeatedly show people who lost weight but didn’t exercise were healthier than matched controls who exercised but didn’t lose weight.

With two-thirds of Americans overweight, there’s a clear potential for fat profits here. In fact, at least a dozen “Don’t Worry, Be Fatty” books have preceded this one, with titles like “Fat?So?” They all tell heavy people what they want rather than what they need to hear.

Mr. Campos merely sings the latest version of that sweet Siren song. Like those songs of Greek mythology, this one kills.

Michael Fumento is a senior fellow at Hudson Institute and a columnist with Scripps Howard News Service. He is the author of “The Fat of the Land” and “BioEvolution: How Biotechnology is Changing Our World.”

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